The Performance of CRUSADE and ACUITY Bleeding Risk Scores in Ticagrelor-Treated ACS Patients Who Underwent PCI
Autor: | Liuan Qin, Shaozhi Xi, Shanshan Zhou, Tong Yin, Jia Liu, Xuyun Wang, Yundai Chen, Jun Liu |
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Rok vydání: | 2017 |
Předmět: |
Male
medicine.medical_specialty Acute coronary syndrome China Ticagrelor Adenosine Time Factors medicine.medical_treatment Hemorrhage 030204 cardiovascular system & hematology Risk Assessment Decision Support Techniques 03 medical and health sciences 0302 clinical medicine Percutaneous Coronary Intervention Predictive Value of Tests Risk Factors Internal medicine Medicine Humans 030212 general & internal medicine Myocardial infarction Prospective Studies Acute Coronary Syndrome Prospective cohort study Aged business.industry Unstable angina Incidence Percutaneous coronary intervention Reproducibility of Results Hematology Middle Aged medicine.disease Surgery Treatment Outcome ROC Curve Area Under Curve Conventional PCI Purinergic P2Y Receptor Antagonists Platelet aggregation inhibitor Female business Platelet Aggregation Inhibitors medicine.drug |
Zdroj: | Thrombosis and haemostasis. 117(11) |
ISSN: | 2567-689X |
Popis: | The performance of the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines) and ACUITY (Acute Catheterization and Urgent Intervention Triage strategy) risk scores for the prediction of major bleeding in ticagrelor-treated acute coronary syndrome (ACS) patients who underwent percutaneous coronary intervention (PCI) is unknown. The aim of the present study is to validate the performance of both scores in a contemporary Chinese cohort of ACS patients hospitalized for PCI and administrated with ticagrelor. From January 2013 to December 2014, a total of 629 ticagrelor-treated ACS patients who underwent PCI were recruited consecutively. The overall rate of major bleeding defined by the BARC (Bleeding Academic Research Consortium) criteria was 1.7%. This incidence increased with the risk category of both the CRUSADE (very low, 0.6%; low, 1.3%; moderate, 1.1%; high, 7.0%; and very high, 13.0%; p = 0.001) and the ACUITY score (low, 0.6%; moderate, 1.4%; high, 4.9%; and very high, 7.0%; p = 0.003). The CRUSADE score demonstrated adequate calibration and discriminatory capacity for the patients as a whole (HL-p [Hosmer–Lemeshow goodness-of-fit test p-value] >0.3; AUC [area under the curve]: 0.78), with the excellent performance in the subgroups of acute myocardial infarction, men, diabetes and those implanted with more than two DESs (AUC: 0.85, 0.80, 0.93 and 0.93, respectively). For the ACUITY score, adequate calibration and discriminatory capacity could be observed for the whole patients (HL-p > 0.3; AUC: 0.78), with excellent performance for the patients with diabetes or those implanted with more than two DESs (AUC: 0.90 and 0.97, respectively). In conclusion, both CRUSADE and ACUITY risk scores performed adequate discriminatory power for the prediction of major bleeding within 30 days in ticagrelor-treated ACS patients who underwent PCI. |
Databáze: | OpenAIRE |
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